Treatment of a comorbid patient with positive HIV status and cirrhosis of the liver in the outcome of chronic hepatitis C

The comorbid condition has an additional negative effect on the outcome of diseases; patients are characterized by reduced immunity. The presence of chronic hepatitis C and simultaneously human immunodeficiency virus is associated with a higher risk of disease progression and the development of liver cirrhosis. In such situations, the procedure for prescribing treatment is determined individually, based on the actual status.

The article presents a clinical case of antiviral treatment of a patient infected with human immunodeficiency virus and cirrhosis of the liver in the outcome of chronic viral hepatitis C. The patient went to an outpatient appointment with an infectious disease specialist in a condition closer to severe. The following complications to the main diagnosis were present: portal hypertension, esophageal varicose veins, hepatolienal syndrome, ascites, hydrothorax, and hydropericardium. At the time of the consultation, the patient had not received antiretroviral therapy.

Given the severity of the manifestation of competing diseases and the lack of adherence to highly active antiretroviral therapy, initially the treatment tactics were aimed at stabilizing the general condition due to the pronounced edematous syndrome. The use of drugs with direct antiviral effect velpatasvir and sofosbuvir in the treatment of chronic viral hepatitis C has allowed to achieve a stable virology response. Adherence to highly active antiretroviral therapy was restored. Gradual inclusion of drugs mad it possible to achieve regression of symptoms. The patient’s well-being and quality of life improved. The combined therapy showed its efficiency.